Article Text
Abstract
Background Terminally cancer patients are often excluded in the loop of end-of-life (EOL) discussion in Korea. Healthcare professionals have difficulty engaging in such communication in a variety of healthcare contexts. A communication model for EOL care planning is demanding in Korea.
Aim To solicit professional opinions on communication with terminal cancer patients and their family caregivers and to develop a model for EOL care planning compatible with clinical environment in Korea.
Methods Using focus group interview, eight doctors and five nurses who provide EOL care for terminal cancer patients in cancer centres or hospice care facility from several provinces of Korea participated in this study.
Results Five themes emerged regarding EOL care planning that included right time, a responsible professional, preparedness for breaking bad news, content of EOL care discussion, and implementation of EOL care decisions. These themes were based for the development of a communication algorithm for EOL discussion among patients with terminal cancer, in which a structural communication steps for delivering a terminal prognosis was specified at the phase of preparedness beginning with determination of a patient decision-making capability, followed by a patient perception of his/her condition, a patient’s wish to know, family decision-making dynamics, and a patient’s and/or family’s readiness for EOL discussion.
Discussion This is one of few studies examining effective communication for EOL discussion in Korea.
Conclusion It is suggested that the proposed context-oriented communication algorithm be communication supporting guidelines for EOL discussion and accordingly, facilitate meaningful improvements in EOL care in clinical practice.